The management of inflammatory bowel disease in children remains a major challenge to patients, their families, and the health care team. This review highlights the past year’s advances concerning epidemiologic studies, new diagnostic considerations, and novel therapeutic approaches. Epidemiologic studies confirmed that Crohn’s disease is being increasingly diagnosed in children, whereas the incidence of ulcerative colitis has remained stable. African-American children are as likely to have inflammatory bowel disease as other children. Serologic assays specific for Crohn’s disease and ulcerative colitis can assist clinicians in screening for inflammatory bowel disease, as well as discriminating between the two diseases. Studies have revealed that osteopenia and antioxidant vitamin deficiency are common and require screening in pediatric inflammatory bowel disease. Increasing experience with immunosuppressive drugs (6-mercaptopurine, azathioprine) point to their efficacy and generally good toxicity profile in pediatric patients.